Wednesday, February 28, 2007

The following commentary was posted on Monday at various online communities (the Daily Kos version received a lot of feedback). Reprinting it here to 'add it to the record' so-to-speak.

This week, Newsweek reported that between 500 and 1,000 OEF/OIF veterans are homeless and that "[military] families [are] sliding into debtas VA case managers study disability claims over many months, and the seriously wounded [require] help from outside experts just to understand the VA's arcane system..." Last week it was the Washington Post. In December it was NPR. And at various times last year it was the Hartford Courant, the San Diego Union Tribune, The Oregonian, the Colorado Springs Independent, Washington Post, or USA Today...

Each delivered exceptional news coverage. What follows is some of the best, along with an invitation to read the opening installment of a new series on combat PTSD appearing on General Wesley Clark's Clark Community Network blog.

Click on 'Article Link' below tags for more...

As many of you know, I've been covering the story of troop reintegration and combat PTSD for a while now. I've noticed (as I'm sure many of you have) that some stories rise above the others, taking the issue to the next level.

Some reporting, like that done by Dana Priest and Anne Hull for the Washington Post last week, is literally life-changing for troops who have been neglected at Walter Reed. This kind of reporting leaves an impression and makes an impact -- and it gets the powers-that-be to stir from their usual institutional sluggishness.

Sure, there's a lot of lousy reporting. Sure, some of the complaints we lob at the media are valid and appropriate. But, every once-in-a-while some reporters and news organizations get it right. They set the bar higher, and their work acts like a marker in time. We can glance back on and guage our progress -- or realize how far we have yet to go.

This first entry isn't necessarily focused on courageous reporting; its focused on a courageous veteran.

After achieving legendary status as the 'Marlboro Man,' 'The Face of Fallujah,' or even Dan Rather's label of the 'Face of War,' Marine James Blake Miller came forward to speak about his PTSD following his tour of Iraq (he took part in the re-taking of Fallujah in November 2004 as well as serving down in New Orleans following Hurricane Katrina).

Miller became the first returning vet to use his war experience and fame to try to educate the American people and shed light on their plight. From CBS:

In November 2004, a photo of a U.S. Marine made the front page of newspapers across the country. The picture is still one of the best-known images of the war. But the man himself has moved on, and is having trouble adjusting to civilian life.

Lance Cpl. Blake Miller of Jonancy, Ky., came to be known as the "Marlboro Marine" when his picture was splashed across the nation. The attention didn't get him any special privileges, and he served his entire combat tour before he and his unit were ordered home. ...

Miller knows he's not alone [in coping with PTSD since coming home].

"A lot of guys have had way worse incidents from being in Iraq," he said. "And I guess it just — it troubled me due to the fact that their incidents may have been more severe, and they weren't suffering from the same things I was. I just didn't understand how it could affect me so dramatically and not affect some of these guys. But a lot of them deal with different ways.

"The more and more I talk to (other guys), the more I found out there were a lot of Marines that are going through same or similar emotions. It's tough to deal with. Being in Iraq is something no one wants to talk about."

The first installment of CCN's Troops & Vets PTSD series has more on Miller's experience and conflict with the war that he fought in.

Running on Page One in the weeks before the third anniversary of the start of the Iraq War, Shankar Vedantam (the same reporter who wrote of the VA's desire to review 75,000 PTSD cases because costs were going through the roof; the public backlash put an end to the idea right quick) shook things up a bit by reporting that 1/3 of our troops might come home with psychological injuries. It seems almost tepid this news by today's standards.

But, after following the combat PTSD story since the summer of 2005, this piece was the first to signal a shift. It became a bellweather of things to come. This was a clear attempt to report seriously on the effects of the war by one of the big media guns -- a war that had gotten a lot of passes, admittedly, up until that time:

More than one in three soldiers and Marines who have served in Iraq later sought help for mental health problems, according to a comprehensive snapshot by Army experts of the psyches of men and women returning from the wars in Iraq, Afghanistan and other places. ...

In questionnaires filled out after their deployment, more than half of all soldiers and Marines returning from Iraq reported that they had "felt in great danger of being killed" there, and 2,411 reported having thoughts of killing themselves, the report said. It did not have comparable data from earlier conflicts.

Earlier research has suggested that 12 to 20 percent of combat veterans develop post-traumatic stress disorder (PTSD), which produces flashbacks, nightmares, and intrusive thoughts that disrupt work and home life. The new study found that Iraq veterans are being diagnosed with mental disorders at the rate of 12 percent per year.

Although Zogby released the results of a first-ever opinion poll of our combat troops serving in Iraq the day before Vedantam's piece, it made the news the same day as the WaPo's front page story, delivering a one-two punch. The results were absolutely stunning:

- Le Moyne College/Zogby Poll shows just one in five troops want to heed Bush call to stay “as long as they are needed”- While 58% say mission is clear, 42% say U.S. role is hazy- Plurality believes Iraqi insurgents are mostly homegrown- Almost 90% think war is retaliation for Saddam’s role in 9/11, most don’t blame Iraqi public for insurgent attacks- Majority of troops oppose use of harsh prisoner interrogation

But it would be a 'smaller' newspaper that would deliver a massive 12-page investigative piece on PTSD on the third anniversary of the launch of the Iraq War. Written by Julie Sullivan (assisted by Torsten Kjellstrand), we learned of the experiences of the Stout family, gaining a detailed view of the struggle some of our veterans -- and their families -- had to face as they coped with the post-traumatic stress disorder that now invaded their lives:

The 2-162 returned to Fort Lewis on March 17, 2005, to thundering cheers, flags and a Rogue "Sunset Ale" specially brewed for the homecoming of a unit that traces its history back to Oregon's famed "Sunset Division." Six months earlier, Bill [Stout] had arrived at Portland International Airport alone. On Sept. 20, 2004, Wendy and the girls waited at the gate holding signs: "I love you Dad!" They threw themselves into his arms. Bill's absence had transformed their lives.

He spiralled downward in the months that followed, writing in a notebook that his family had found:

"I used to feel normal. Since I've been to Iraq, and seen and done the things I did, PTSD has taken control of me. I can't be happy anymore. I can't stop the nightmares of losing Ken. It drives me crazy, thinking about it. I haven't slept for months, my stomach is always upset. No matter how hard I've tried, nothing goes right with my family. I can't put it together. I am always angry. I have to force myself to be social in any way. I hate myself and life now. No matter how hard I try, I just can't get it together. The calm ways of this life are making me crazy. I feel like I always have to be going 120 mph. I feel like I should constantly be in a firefight. Even with medication the doctor has given me, I feel like I can't control myself anymore."

It was more detailed than any other account at the time and made a big stir.

Another third anniversary offering to come out of the west coast was Rick Rogers' piece on the practice of sending troops back to the combat zone with their own supply of antidepressant and anti-anxiety medicine; service members who had been having mental health issues were routinely sent into combat for a second, third or fourth tour. This was the precursor to the in-depth Hartford Courant investigation that was coming on strong on this report's heels.

The redeployments are legal, and the service members are often eager to go. But veterans groups, lawmakers and mental-health professionals fear that the practice lacks adequate civilian oversight. They also worry that such redeployments are becoming more frequent as multiple combat tours become the norm and traumatized service members are retained out of loyalty or wartime pressures to maintain troop numbers.

Sen. Barbara Boxer hopes to address the controversy through the Department of Defense Task Force on Mental Health, which is expected to start work next month. The California Democrat wrote the legislation that created the panel. She wants the task force to examine deployment policies and the quality and availability of mental-health care for the military.

“We've also heard reports that doctors are being encouraged not to identify mental-health illness in our troops. I am asking for a lot of answers,” Boxer said during a March 8 telephone interview. “If people are suffering from mental-health problems, they should not be sent on the battlefield.”

The Hartford Courant completed an exhaustive investigation based on Freedom of Information Act requests which concluded that "U.S. military troops with severe psychological problems have been sent to Iraq or kept in combat, even when superiors have been aware of signs of mental illness." After this initial investigation, reporters Lisa Chedekel and Matthew Kauffman continue cranking out one important report after another, delivering the best reporting on this issue:

The U.S. military is sending troops with serious psychological problems into Iraq and is keeping soldiers in combat even after superiors have been alerted to suicide warnings and other signs of mental illness, a Courant investigation has found.

Despite a congressional order that the military assess the mental health of all deploying troops, fewer than 1 in 300 service members see a mental health professional before shipping out. Once at war, some unstable troops are kept on the front lines while on potent antidepressants and anti-anxiety drugs, with little or no counseling or medical monitoring. And some troops who developed post-traumatic stress disorder after serving in Iraq are being sent back to the war zone, increasing the risk to their mental health.

These practices, which have received little public scrutiny and in some cases violate the military's own policies, have helped to fuel an increase in the suicide rate among troops serving in Iraq, which reached an all-time high in 2005 when 22 soldiers killed themselves - accounting for nearly one in five of all Army non-combat deaths.

The Courant's investigation found that at least 11 service members who committed suicide in Iraq in 2004 and 2005 were kept on duty despite exhibiting signs of significant psychological distress. In at least seven of the cases, superiors were aware of the problems, military investigative records and interviews with families indicate.

Michael de Yoanna for CSIndy and CBS' Armen Keteyian teamed together for the rumble in what would later be an earthquake of a December NPR investigation into the abusive treatment of soldiers at Fort Carson, Colo. They found that soldiers with PTSD and other psychological injuries were "saying members of the Army Command [were] simply paying lip service, at best, to PTSD — hindering their treatment and upending their careers:"

In the face of what some are calling an epidemic of PTSD in the military, nearly a dozen soldiers at Fort Carson told CBS News that their cries for mental health either went unanswered or they found themselves subject to unrelenting abuse and ridicule.

Kaye Baron is a clinical psychologist in private practice in Colorado Springs, Colo. Each week, she counsels up to 25 soldiers and their families who are either unwilling or unable to face their problems while on base. "I think it's a very big problem," says Baron. "They could potentially lose their promotion potential, or just feeling like they're not able to advance in their career. That it's kinda over for them."

Lt. Col. Eric Kruger, Commanding Officer of the 2nd Brigade Combat Team at Fort Carson, says he's concerned that soldiers aren't seeking help due to fears of fearing ridicule or reprisal. "It's a tremendous concern," he says. "You don't want a soldier not to seek help for anything. They're our No. 1 asset. Leaders have to engage that every day — and in my experience here, we do.

OK. So, psychological injuries are one thing. They are harder to 'see' than physical wounds received on a battlefield. But what happens when reporter Gregg Zoroya files an article which reported that the House and Senate Appropriation Committees were poised to slash by half TBI funding used for research and treatment of war-related brain injuries in its 2007 Defense appropriation bill? Outrage. Traumatic brain injury is the signature wound of our nation's current wars. As of January 2006, 20% of those injured in Iraq had TBI. Cutting funding when it is most needed is reckless and immoral, and after this explosive piece hit the stands it wasn't long before the public backlash was sure and swift. Funding restored.

Congress appears ready to slash funding for the research and treatment of brain injuries caused by bomb blasts, an injury that military scientists describe as a signature wound of the Iraq war. House and Senate versions of the 2007 Defense appropriation bill contain $7 million for the Defense and Veterans Brain Injury Center — half of what the center received last fiscal year.

Proponents of increased funding say they are shocked to see cuts in the treatment of bomb blast injuries in the midst of a war. "I find it basically unpardonable that Congress is not going to provide funds to take care of our soldiers and sailors who put their lives on the line for their country," says Martin Foil, a member of the center's board of directors. "It blows my imagination."

The Brain Injury Center, devoted to treating and understanding war-related brain injuries, has received more money each year of the war — from $6.5 million in fiscal 2001 to $14 million last year. Spokespersons for the appropriations committees in both chambers say cuts were due to a tight budget this year. "Honestly, they would have loved to have funded it, but there were just so many priorities," says Jenny Manley, spokeswoman for the Senate Appropriations Committee. "They didn't have any flexibility in such a tight fiscal year."

Prior to last week's Washington Post/Walter Reed shockwave, NPR held the title for creating the most significant tremors in the military reporting landscape. Daniel Zwerdling reported on conditions at Fort Carson, Colo., where officers were said to stand in the way of soldiers desperate to get help for psychological problems or PTSD; some had even been kicked out of the Army rather than given the help they needed. The story created such public outcry that Senators Barbara Boxer (D-CA), Christopher Bond (R-MO) and Barack Obama (D-IL) immediately asked the Pentagon to open an investigation into the allegations.

[Some] soldiers who've returned to Ft. Carson from Iraq say they feel betrayed by the way officials have treated them. Army files show that these were soldiers in good standing before they went to Iraq, and that they started spinning out of control upon their return.

Since the war in Vietnam, military leaders have said that soldiers who are wounded emotionally need help, just like soldiers missing limbs. "The goal, first and foremost, is to identify who's having a problem," says William Winkenwerder, assistant secretary of defense for health affairs. "Secondly, it's to provide immediate support. And finally, our goal is to restore good mental health."

The Army boasts of having great programs to care for soldiers. The Pentagon has sent therapists to Iraq to work with soldiers in the field. And at Army bases in the United States, mental-health units offer individual and group therapy, and counseling for substance abuse. But soldiers say that in practice, the mental-health programs at Ft. Carson don’t work the way they should.

And from these big news stories, we arrive back at the Washington Post and Newsweek pieces of the past two weeks. Both are making significant changes possible like good reporting should. Three cheers for the reporters whose work I've tried to briefly highlight here; they certainly deserve a ^5 from us.

Keep it coming...

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While a wide variety of events can trigger what's called post-traumatic stress disorder, this PTSD blog focuses solely on the combat-related variety.
As a new generation of warriors returns to civilian life and seeks out resources, PTSD Combat is here to help.

Considerable Quotes

"The first shamans earned their keep in primitave societies by providing explanations and rituals that enabled man to deal with his environment and his personal anguish. Early man, no less than we, dealt with forces that he could not understand or control, and he attempted to come to grips with his vulnerablity by trying to bring order to his universe." -- Richard Gabriel in No More Heroes

"War stories end when the battle is over or when the soldier comes home. In real life, there are no moments amid smoldering hilltops for tranquil introspection. When the war is over, you pick up your gear, walk down the hill and back into the world." -- OIF vet John Crawford in The Last True Story I'll Ever Tell

"After wars' end, soldiers once again become civilians and return to their families to try to pick up where they left off. It is this process of readjustment that has more often than not been ignored by society. -- Major Robert H. Stretch, Ph.D in Textbook of Military Medicine: Vol. 6 Combat Stress

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